The nurse receives the patient in the postanesthesia recovery unit and assesses the epidural analgesic infusion. Which is the nurse's priority?
a. The filter needle is attached to the catheter tubing.
b. The distal end of the tubing is attached to the catheter.
c. The infusion contains an opioid and a local anesthetic.
d. The pump settings match the provider prescription.
C
Combining an opioid with a local anesthetic agent increases the patient's risk of complications from epidural analgesia because adding another agent exposes the patient to the risks of both medications, risks from drug-drug interactions, and risks of epidural analgesia. The filter needle is used to remove microscopic debris as the medication is withdrawn from the medication vial and is removed before injecting the medication into the infusion fluid. A filter needle piggybacked into the epidural catheter is likely to increase the pressure necessary to pump the infusion through the catheter and activate the high-pressure alarm on the infusion pump. The nurse should replace the filter needle with a standard needle or needleless adapter. Attaching the distal end of the tubing to the epidural catheter is correct. Matching the pump settings to the provider prescription is expected nursing behavior.
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